Provider Demographics
NPI:1245670058
Name:PARRY, WILLIAM DEWITT (CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DEWITT
Last Name:PARRY
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 BAIRD RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1302
Mailing Address - Country:US
Mailing Address - Phone:215-620-6792
Mailing Address - Fax:
Practice Address - Street 1:520 BAIRD RD
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1302
Practice Address - Country:US
Practice Address - Phone:215-620-6792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009965235Z00000X
CASP195051235Z00000X
FLSA11676235Z00000X
MASP8720SL235Z00000X
VA2202006858235Z00000X
TX108454235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist